Indian doctors remove 53 stones from salivary duct and gland by endoscope

Indian doctors gave a new lease of life to a 66-year-old Iraqi woman by operating and removing 53 stones from her salivary duct and gland. The surgery was performed at the Sir Ganga Ram Hospital and it took over two hours.

The woman patient, hailing from Baghdad, was suffering from recurrent attacks of pain and swelling of the right-sided parotid gland after having food or drink. This wreaked havoc on her life with her having to place severe restrictions on what she could eat, the hospital said in a statement.

"After the consultation, she was diagnosed to have multiple stones in her right-sided parotid duct with the largest stone being about 8 mm in size stuck midway between origin and end of the duct. Doctors operated on her and removed 53 stones from salivary duct and gland," it said.

According to Dr Varun Rai, ENT Consultant, Sir Ganga Ram Hospital, the biggest challenge was to remove all the stones without causing any injury to the gland or the thin (3 mm wide) duct.

"The stones were removed painstakingly one by one using baskets and forceps without any cut in the body. The entire procedure took two hours," he said.

Rai added that after an extensive review of worldwide literature, a single parotid gland having "more than 25 stones within the parotid duct is not previously reported".

Most of the doctors she had shown to in Iraq and surrounding regions suggested a radical procedure of removal of the parotid gland, which would inevitably leave an unsightly scar on the face and in all likelihood leave her face paralysed, the hospital claimed.

She came to India having heard of a procedure called "sialendoscopy" where a small endoscope measuring just 1.3 mm is inserted into the duct of the parotid gland and the cause of obstruction is directly addressed.

The parotid glands are a pair of mainly serous salivary glands located below and in front of each ear canal.

She underwent the procedure at the Sir Ganga Ram Hospital, where the endoscopy of the parotid duct revealed that the large stone seen on CT scan was actually a cluster of smaller stones impacted together, the doctors said.